(Sinequan) Amitriptyline (Elavil) Clomipramine (Anafranil) Imipramine (Tofranil) Desipramine (Norpramin) Nortriptyline (Aventyl, Pamelor) High High High Moderate Low Low 3. Overdoses from tricyclics are common because depressed patients may ingest large amounts of the drug in an attempt to commit suicide, and these drugs have a narrow therapeutic index. Treatment of an overdose involves a. Supportive management b. Lidocaine to reduce arrhythmias c. Physostigmine to reverse anticholinergic

Quinidine is the stereoisomer of quinine. Although quinidine can be used to treat malaria, it is more commonly used to treat arrhythmias. Both drugs prevent the parasite from polymerizing heme. ii. Side effects include cinchonism (nausea, vomiting, tinnitus, vertigo) and arrhythmias. d. Mefloquine (Lariam) is a quinine derivative that has a long half-life and can be administered orally. It is thought to work by damaging the parasite’s cell membrane. e. Tetracyclines also have antimalarial